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    Howard has a point, although I think there are big developments here. I have attended too many "consultations" that are no more than an exercise in having an exercise. I hope that the opening up of the "mystique" of healthcare commissioning will lead to better accountability and some democracy. Too much democracy would be counter-productive though - I don't call in a plumber only to tell her/him how to change the ballcock. (Sorry - couldn't think of a better example!!)

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